Less orthodox psychological interventions.
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Biomedical subjects
Publications and source records attributed to A Bentovim.
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An account is given of the development of a treatment project for sexually abused children and their families. We review incidence data which indicate that sexual abuse of children is likely to be a far more frequent problem than has been recognised and cause an appreciable degree of psychological damage. Professional responses to this are confused and treatment facilities limited. Sexual abuse is seen as an expression of severe relationship problems in the family and therapeutic provision is made, therefore, not only for the abused child but for other members of the family (including both parents). The method adopted is to offer group therapy to the child, mother, and father and regular family meetings with professionals in the community, concerned with care and protection of children. Clinical data on the first 56 children treated are discussed and our approach to treatment is evaluated.
Questionnaires were circulated to 1,599 family doctors, police surgeons, paediatricians, and child psychiatrists to determine the frequency and nature of child sexual abuse in the United Kingdom. At least three per 1,000 children are currently being recognized as sexually abused sometime during their childhood. The majority of cases reported involved actual or attempted intercourse, and 74% of the perpetrators were known to the child. Family disturbance was noted in 56% of the cases. The most common outcome (43%) was criminal prosecution of the perpetrator. Area Review Committees had no clear policy for the management of sexual abuse. Before it is possible to protect children and to develop therapeutic services for the family, it will be necessary to acknowledge that sexual abuse is part of the child abuse spectrum.
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Six cases of persistent non-accidental poisoning of children by their parents are reported. Certain features may draw attention to the diagnosis, particularly bizarre symptoms and signs with no apparent pathological explanation, and toxicological analysis should be carried out to obtain rapid confirmation of the diagnosis. The underlying disorder may include marital conflict, overinvolvement between parent and child, or drug abuse in the parents. A suggested plan of action for managing this problem is outlined.
It is easy to be over-simplistic about breast-feeding--what determines the choice of the breast; what causes rejection of breast-feeding as a feeding method; what determines success and what its failure? In fact, a bewildering range of factors, physical, psychological and sociological play a part. How can these be related to each other and ordered in general and for the individual? A general systems theory approach, in which the elements are envisaged as interacting dynamically, seems to offer a possible satisfactory explanatory model. Moving from social systems to the individual's intrapsychic system helps to understand the complexity of emotions aroused about the breast and breast-feeding. Shame and anxieties are seen to arise from the confluence of life history and current events. Intervention is necessary at many levels--societal, family and individual--if breast-feeding is to be re-established as the feeding method of first choice.
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